Health equity in economic and trade policies

AIDS drug access alert: Abbott denies new drugs to Thai people
AIDS Healthcare Foundation, 14 March 2007

US drug giant Abbott Laboratories has banned its new drugs in Thailand in response to the Thai government's decision to protect the health of its citizens by issuing a compulsory license on Abbott's AIDS drug Kaletra. Abbott's decision could potentially deny access to lifesaving drugs to the more than 500,000 people living with HIV/AIDS in Thailand, as well as to others with serious health conditions. The company's move has sparked outrage throughout the global health community.

AIDS drugs for Africa deal is off as pharma giants pull out
Townsend A: The Independent, 3 December 2006

Some of the world's biggest pharmaceutical companies, including FTSE 100 giant GlaxoSmithKline, are reported to have failed to sign a formal agreement that would ensure HIV and AIDS patients in poor nations receive vital drugs. The agreement was drawn up during three years of talks between companies and the International Federation of Chemical, Energy, Mine and General Workers' Unions (ICEM), which has 20 million members and 400 affiliated unions worldwide.

Alarm escalates over delayed generic drug shipments to developing countries
New W: Intellectual Property Watch, 6 March 2009

Oxfam International, Health Action International (HAI) and Knowledge Ecology International (KEI) have voiced their alarm over recent seizures by the Dutch government of shipments of legitimate generic pharmaceuticals passing through Europe on their way to developing countries. The recent seizure of legitimate generic antiretroviral medicines in transit from India to Nigeria by Dutch customs authorities could lead to HIV-positive Nigerian patients missing critical treatment. They have called on the European Union to review and modify its regulations on counterfeiting that are prompting the seizures. They also urged the EU to reconsider inclusion of its regulation in regional free trade agreement negotiations. If it does not, ‘this could prove disastrous for access to medicines in some regions,’ they said.

Alcohol marketing in Africa: not an ordinary business
Obot IS: African Journal of Drug and Alcohol Studies, 12(1), 2013

Alcohol was the cause of nearly five million deaths globally in 2010, an increase of over one million deaths recorded ten years earlier. It was the leading risk factor for disease in southern sub-Saharan Africa (SSA). Several factors account for the increasing harm associated with alcohol in Africa among which are the availability of a wide variety of alcoholic beverages, rising urban populations, more disposable income to purchase alcohol, and unrestrained marketing and promotion of alcohol. Using a variety of strategies, producers of alcohol target young people and women with aspirational messages and other exhortations in an onslaught of marketing and promotion. The author argues that missing in the discussion on alcohol in most African countries is the understanding that alcohol marketing is not an ordinary economic activity and that the business of alcohol (an addictive substance with high potential for harm) can subvert individual rights and democratic principles. This paper discusses these issues with particular attention to the harms caused by alcohol (to drinkers and non-drinkers alike), the potential for far-reaching harms to individuals and the society at large if the present scenario continues, and how these harms can be averted or minimized with the implementation of evidence-based policies.

All roads lead back to China
Sharife K: Pambazuka News 531, 26 May 2011

Across Africa, China has become known as the agent of mass construction, bartering infrastructural development – chiefly mining-specific – for long-term access to strategic resources. Through this mechanism, Ghanaian cocoa, Gabonese iron and Congolese oil have been swapped for construction of dams (Bui, Poubara, and River Dam), allowing Chinese corporations such as Sinohydro to capture Africa's hydropower market. The 'barter system' enables China to export goods and labour and to 'import' recycled project capital and African resources. In the process, the author of this article argues that China has activated the same 'Western' capitalist vehicles of engagement but with one noticeable difference: prior to Beijing's entrance, just 4% of foreign direct investment (FDI) was earmarked for infrastructure. China has constructed stadiums across the continent, as well as buildings and special economic zones. Though Zambia was pegged as the third largest recipient of Chinese investment in Africa, Zambian labour unions appear apprehensive about Chinese FDI as the means of national development, stating that Chinese FDI has had modest impact on national development, with overall negative impacts on the labour market. In Zambian mines, the bulk of the work is reported to be subcontracted to Chinese workers and companies, leading to complaint of displacement of local workers.

Amendment to the TRIPs Agreement: The issue of universal access
TRALAC Discussions: Kruger P

On the 6th of December 2006 the WTO General Counsel agreed to amend the TRIPs Agreement by permanently incorporating an earlier waiver. Paul Kruger, a TRALAC researcher, comments on the decision to "Amendment to the TRIPs Agreement: The issue of universal access".

An analytical framework for trade in health services
Kiel Institute for the World Economy, Working Paper No. 441

The paper delivers an analytical framework for the assessments of this new sector of international trade which takes into account both the ‘general welfare aspects’ and the effects for the achievement of general ‘health system goals’. Trade in Health Services is split up according to the four modes of service supply introduced by the General Agreement of Trade in Services (GATS). For each mode examples are enclosed and the current level of trade is analysed. It is also examined what are the major obstacles for trade in these modes and what liberalization perspectives are given. The subsequent discussion and plausibility considerations of how each mode may contribute to improve efficiency as well as equity in national health systems is a systematic starting point for further research. It provides a first insight in how trade in Health Services could help to overcome resource constraints in national health systems as well as allude to the potential risks of which sight shouldn’t be lost.

An ecological approach to non-communicable disease prevention in the workplace
De Villiers A, Senekal M and Fourie J: Occupational Health Southern Africa 17(4) July-August 2011

Non-communicable diseases (NCDs) are the leading cause of death globally, killing more people each year than all other causes combined. Furthermore, behavioural risk factors for NCDs fall increasingly on poorer people within all countries, mirroring the underlying socio-economic determinants. The need for prevention efforts through well-planned, cost-effective and feasible interventions across all levels of society is therefore obvious, the authors of this paper argue. The workplace is argued to provide an important setting for ecological models that ensure the both the policies and the environments that enable health.

An EPA secures a predictable trade regime in Ugandan export market
Nahamya SG: EPA Flash News

This paper argues that Uganda needs a secure and predictable trading regime with their main export market in the EU. This makes an EPA essential. The possible shocks that normally come with any change have been well anticipated and safeguards built into the negotiations and ultimately the EPA. Safeguards include for example designation of certain products as sensitive and therefore not eligible for tariff reduction (liberalization) when imported into Uganda, longer (up to twenty five years) tariff phase-down/reduction periods for products where tariffs may be reduced, and reservation of the right to restrict imports should they threaten to cause injury to domestic industry.

Further details: /newsletter/id/32257
An interview with Alhaji Mohamed Daramy, ECOWAS Commissioner for Trade, Customs and Free Movement of Persons and Goods
Trade Negotiations Insights 9(5): June 2010

In this interview, Alhaji Mohamed Daramy affirms his support for economic partnership agreements (EPAs) but warns that the required fiscal reforms will not come without an upfront cost, and he believes an EPA regional fund should be created to support this process, to which the European Union (EU) should contribute. He argues for a five-year transition period after the signature of an EPA, after which an efficient indirect taxation system should be put in place. Within this period, ECOWAS will aim to move some activities from the informal sector to the formal economy. The certainty and sustainability of financing ECOWAS activities will then be reviewed at this point.

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